Shraddha Eye Bank

Eye Bank Organisation
Need for donor tissue?
What is an Eye Bank?
How to become an eye donor?
Instructions for next of Kin and family physician of donor?
Instructions to donor's next of kin regarding care of donor eyes?
Instructions for recipients of donor eyes?
Ethical issues in Eye Banking (Code of Ethics)?

Collection of eyes

Processing of the donor eyes and storage in eye bank

Evaluation of donor tissue and distribution

Need Of Donor Tissue

In India there about 10 million people who are blind (NPCB-WHO). Out of this 80% of the blindness is preventable or curable. There are 2.5 million corneal blinds that require corneal grafting. Some of them are their 1st or 2nd decade of life. These visions can be improved by corneal transplantation. In this operation the damaged opaque corneal is replaced by a healthy one, taken from the eye of a recently deceased person. There is a severe lack of availability of donor eyes in India. That's why only 6-7 thousand corneal grafting operations are done every year. But unfortunately about fifteen to twenty thousand new victims of corneal blindness are added each year to the already waiting 1 million corneal blinds. There are enough qualifies eye surgeons but the corneal grafting operations cannot be performed because of the donor eyes. This is where eye donation offers hope. One eye donation can give vision to 2 persons

Nethradhama Super Speciality Eye Hospital set up the Shraddha Eye Bank in 2004. The SEB is a member of the Eye Bank Association of India (EBAI) and Certified by Government of Karnataka under Human Transplantation Act for Collection of Eyes.

The SEB has the infrastructure, facilities, and staff expertise for eye banking, from core activities like cornea retrieval, evaluation and distribution, to wider functions such as training, research and the conducting of public awareness campaigns.

The Core Activities

Cornea Retrieval
Evaluation and Distribution

Wider functions

Training
Research
Conducting public awareness campaigns

What is Eye Bank

What is an Eye Bank?

It is an organization, which deals with the collection, storage and distribution of donor eyes for the purpose of corneal grafting.

What is Corneal Grafting?

Corneal is the bright transparent bulging watch glass like cover over the iris lens diaphragm. In diseases like Trachoma, corneal ulcers due to herpes fungus & bacteria and in many other diseases aphakic & pseudophakic bullous keratopathy the cornea becomes hazy and opaque thus causing partial or total loss of sight. In corneal grafting these diseases and opaque cornea is replaced by a healthy transparent cornea taken out from a donor eye.

How does the Eye Bank Functions?

The Eye Bank collects the eyes

Of voluntary registered eye donors after their death

Of those deceased persons whose enlightened relatives agree to donate the eyes as a service to the humanity

From hospital deaths

From post mortem eyes, when donated. These eyes are processed in the Eye Bank and are supplied to eye surgeons for corneal grafting and other sight restoring operations.

What is eye donation?

Eye donation means people pledging today, to donate their eyes after death, to be used for corneal grafting operations, which restore the vision to the corneal blind persons. The eyes of the deceased person, who has not pledged his eyes, can be donated by the next of his kins.

What can the Eye Bank do for you?

Noble are those who continue to serve the mankind even after death. Eye Bank offers you a road to immortality and nobility.

What does the religion say in regard to Eye Donation?

All religions preach service to mankind even after death. You can serve your religion through the eye bank

How do you donate your eyes?

You sign and mail the voluntary eye pledge card obtainable from the Eye Banks. You will receive back some instructions and Eye donor pocket card to be carried by you.

How soon must eyes be removed?

Eyes should removed as soon as possible, preferably within 6 to 8 hours of death

How does the Eye Bank collect donated eyes?

The Eye Bank is informed by the next of kin or the family physician immediately after the death of the donor (day or night by telephone). The Eye Bank then takes care of all arrangements without delay.

How long can the eyes be preserved?

Eyes are used within 49-72 hours. However, by special preservation methods, they can be stored up to 2 weeks and ever for a year.

How are these eyes used?

The eyes thus obtained are properly examined and preserved aseptically in the Eye Bank. They are supplied free of charge to eye surgeons for the treatment of their patients.

Is prior examination of donor eyes essential?

No, all donated eyes are utilized by the Eye Bank either for sight restoration (if suitable) or for research to cure blindness.

Does removal of eyes cause disfigurement of the body?

No, Removal of the eyes is done carefully and skillfully without causing any disfigurement of the face.

Can a person with weak eyes sight donate his eyes?

Yes. Weak eyesight has no effect on donor cornea and subsequent corneal grafting operation. Even operated eye with healthy cornea can be used for grafting.

Can the whole eyeball be grafted?

No. It has not yet been successful. Further research in this field is in progress

Are there certain types of eyes, which cannot be used?

All donated eyes are useful. The majority can be used for corneal grafting. But some of eyes from certain diseases are not fit to be used for corneal grafting, however, these are valuable for research purpose to prevent blindness.

How to become an Eye donor

The following are the instructions to enroll as:

Can a person with weak eyes sight donate his eyes?

Fill in the Eye Pledge Form and mail it to the Eye Bank.

Your name will be registered as voluntary eye donor on receipt of your pledge card and you will receive a pocket donor card giving a Donor Number for future correspondence.

Carry your Donor Card in your diary/pocket.

Intimate the Eye Bank about any change in your address.

Call on us for any information regarding Eye Banks.

Convince others to follow your noble deed in this service to mankind " Your eyes may return two sightless persons to a useful place in society".

Instruction For Next Or Kin And Family Physician Or Eye Dono

The role of the next of kin and family physician (of voluntary Eye donor) is also of utmost importance. They may act according to the word of the deceased. The guidelines for them are as under:

In case the voluntary eye donor dies, please inform immediately, to the nearest Eye Bank. The eye could be collected by any nearest eye bank irrespective to the place where registration has been done.

The information should be conveyed to the Eye Bank as early as possible preferably within 2-3 hours of the death of the donor.

Please give full co-operation to the personnel who come to remove the eyes.

The doctor will take necessary steps to avoid any disfigurement of the body of the removal of the eyes.

Instructions to donor's next or kin regarding care of donor eyes

The care of donor's eyes is very necessary to keep them viable for transplantation. The following precautions may be observed.

Eyelids should be closed immediately after death. These should be taped and any antibiotic drop/ointment may be put if available at home.

Elevate head.

To ensure that the eyes will be received by the Eye Bank in good condition, it is well to keep the body in a cool place esp. in summer months.

Ice packs may be put on the closed eyelids.

Stop the fan

Instruction for recipients of donor eyes

There are number of needy persons requiring corneal grafting. They have to adhere to the following guidelines

Patients will be seen in the corneal clinic to assess the eyes for corneal grafting. The cases where corneal grafting is indicated shall be selected and registered.

For operation they will be informed to wait for hospital call, which will be by queries.

In case there is change of address the patients are requested to inform to Eye Bank with proper reference.

Donor's name shall not be disclosed to the recipients as it is UNETHICAL, next to kin of donor will also not be told the recipients identity.

No patients can demand for a particular donor corneal to be transplanted in his/her eyes.

The donor's family after actual donation gets the certificate (appendix XX) of this supreme sacrifice.

Ethical issues" in Eye Bank Organization

The needs for laying down ethics in Eye Bank organization is in view of various reasons

It is a voluntary donation and is free.

The tissue availability is scarce and the demand is enormous.

It involves interaction of Eye Bank/Collection Centers personnel with donor's (deceased) relations who are always under emotional stress.

Involvement of various voluntary agencies interested in the cause of eye donation.

To safe guard against some minor issues which are unnecessarily given publicity in media and can cause harm to eye donation movement.

Whether an Eye Bank should recognize eye surgeons as well as the institutions where the surgery is to be performed for corneal surgery?

Which types of "Eyes" should not be used for transplantation of cornea?

Should one use cornea of a deceased whose medical history is not know?

Can anyone donate the eyes like kidneys while alive?

Who will enucleate the eyes, Ophthalmologists or general practitioner?

Whether Eye Bank should give priority?

To which type of surgeons

To patients or their scientific indications

To those who collect eyes or mobilize eye donation

To patients recommended by collection centers.

All such issues must come under preview while laying down code of ethics. At Shraddha Eye Bank, we have a general and specific " Code of Ethics" which are as under. This is in consonance with "Code of Ethics" for International Eye Banking but modified in view of our prevailing conditions.

General Code Of Ethics

Eye Banks shall not compete with one another.

Eyes must be collected once donated irrespective of inconvenience or unsuitability (at first sight).

Eye tissue shall neither be bought nor sold.

Eye tissue is distributed without discrimination based on race, creed or nationality

Eye tissue shall/ be provided only to another eye bank/ qualified ophthalmologist on request.

The wishes of the immediate family shall be respected in carrying out donor's eye pledge

The name of donor and recipient shall not be disclosed without written consent.

Eye pledges shall be solicited in dignified manner.

Fund raising shall be ethically conducted.

All public information shall be medically approved.

Can anyone donate the eyes like kidneys while alive?

Who will enucleate the eyes, Ophthalmologists or general practitioner?

Whether Eye Bank should give priority?

General Code Of Ethics

Further we have tried to enlarge the scope and explain the specific code ethics at various levels of functionaries of Eye Banking

For Eye Bank

For Surgeons

For Eye collection center

For collection of Eye From unclaimed bodies

For disposal of Eye Balls

Code Of Ethics For Eye Bank

Eye Bank will not enter in rivalry with other Eye Banks.

There should be free exchange of tissue (Eyes) between Eye Banks.

No eye is to be enucleated during life.

Eye tissue shall neither be bought nor sold.

Eye tissue shall be distributed without discrimination based on race, creed, color or nationality.

The identity of the donor is not be disclosed to the recipient.

The identity if the recipient is not disclosed to Donor's kins. However, the donor's relatives may be informed of the use of the eyes and the results of the operation.

The donor's identity is not disclosed. However, all available medical history of the donor is reveled to the surgeon.

Eye Banks shall maintain waiting lists according to priority of needs and maintain proper records of receipt and distribution of eyes.

They shall not use the corneal tissue for corneal grafting which is contraindicated for such use.

The eye tissue shall be distributed only to qualified ophthalmologist on request.

The identity of the donor is not be disclosed to the recipient.

They shall not do commercial publicity. However, publicity for the furtherance of Eye Donation might be undertakes especially by the state controlled medical like television and radio.

Code For Eye Surgeons

They should not buy or sell the donor cornea.

They should be competent to perform corneal surgery

They should get the cornea from recognized Eye Banks.

The surgeon shall not divulge the donor's identity to the recipient.

Should possess all possible medical details of donor as well as details about cornea.

Codes For Eye Collection Centres

They will be polite, courteous and sympathetic with donor's relatives/Kins The enucleation is done in a schedule place.

A medical practitioner trained in enucleation of cadaver eye or ophthalmologist should remove the eye.

They have to be respectful to the body of the deceased (cadaver).

External mutilation of the body must be avoided.

The enucleation should be done aseptically and all steps should be taken properly like stitching of conjunctiva to stop blood oozing.

Artificial Eye may be fitted and the relatives be told of it.

Legal Aspects

The transplantation of human organs bill, 1994 was presented in parliament in 1992 and passed as Act no. 42 of 1994 as the transplantation of human organs Act 1994 ad amended in 1995.

This provides for the regulation of removal, storage and transplantation of human organs for therapeutic purpose and for the prevention of commercial dealings in human organs. All the Eye Banking and collection of eyes has to be done as per this act.

Collection Of Eyes

When the "donor call" comes; be sure to get as much data as possible from the caller, such as donor's name, age diagnosis, time of death and the caller's knowledge about possible cause of death in the Donor Call-Initial Information. Qualified Doctors with one assistant and driver will reach site at the earliest possible for enucleation procedure

Processing Of Donor Eyes And Storage In Eye Bank

Eyes are received from donors in wide mouthed eye collection bottles containing eye stands to hold eyes. Moist cotton is placed at the bottom of the eye collection bottle. After eye collection Microbiological Investigation & Preservation of Cornea is done in the eye bank.

Evalutation Of Donor Tissue And Its Distribution

The acceptability of all corneas and/or eyes received is subject to several criteria and evaluation is noted in the Cornea Evaluation Form. The eyes/corneal buttons when ready after processing will be distributed to the other eye Banks/ Corneal surgeons. The proper records of receipts and disimbursement of the donor eye is ensured. The proper indenting requests and issuing of the eye is done and the utilization of the eyes properly is ensure, in compliance to the Ethical codes of the eye bank